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Vitamin K Antagonists and Cognitive Decline in Older Adults: A 24-Month Follow-Up.
Nutrients. 2018 May 24; 10(6)N

Abstract

Vitamin K participates in brain physiology. This study aimed to determine whether using vitamin K antagonists (VKAs), which interfere with the vitamin K cycle, were (i) cross-sectionally associated with altered cognitive performance, and (ii) independent predictors of cognitive changes in older adults over 24 months. Information was collected on the use of VKAs (i.e., warfarin, acenocoumarol, and fluindione) among 378 geriatric outpatients (mean, 82.3 ± 5.6 years; 60.1% female). Global cognitive performance and executive functions were assessed with Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) scores, respectively, at baseline and after 12 and 24 months of follow-up. Age, gender, body mass index, mean arterial pressure, disability, gait speed, comorbidities, atrial fibrillation, stroke, carotid artery stenosis, leukoaraiosis grade on computed tomography (CT) scan, psychoactive drugs, antidementia drugs, blood-thinning drugs (i.e., anticoagulants other than VKAs, antiplatelet medications), serum creatinine levels, and vitamin B12 concentrations were considered as potential confounders. Using VKAs was associated with lower (i.e., worse) FAB score at baseline (adjusted β = -2.1, p = 0.026), and with a decrease in FAB score after 24 months (adjusted β = -203.6%, p = 0.010), but not after 12 months (p = 0.659). Using VKAs was not associated with any change in MMSE score at baseline (p = 0.655), after 12 months (p = 0.603), or after 24 months (p = 0.201). In conclusion, we found more severe executive dysfunction at baseline and incident executive decline over 24 months among geriatric patients using VKAs, when compared with their counterparts.

Authors+Show Affiliations

Department of Geriatric Medicine, University Memory Clinic; Research Center on Autonomy and Longevity (CeRAL), University Hospital, F-49933 Angers, France. Antoine.Brangier@chu-angers.fr.Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada. guylaine.ferland@umontreal.ca.Department of Geriatric Medicine, Institut du Vieillissement, University Hospital, INSERM-U1027, F-31000 Toulouse, France. rolland.y@chu-toulouse.fr.Department of Geriatric Medicine, University Memory Clinic; Research Center on Autonomy and Longevity (CeRAL), University Hospital, F-49933 Angers, France. jegautier@chu-anger.fr.Institut de Santé Publique, d'Épidémiologie et de Développement ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Université Bordeaux, F-33000 Bordeaux, France. Catherine.Feart@isped.u-bordeaux2.fr.Department of Geriatric Medicine, University Memory Clinic; Research Center on Autonomy and Longevity (CeRAL), University Hospital, F-49933 Angers, France. Cedric.Annweiler@chu-angers.fr. Health Faculty and UPRES EA4638, University of Angers, F-49100 Angers, France. Cedric.Annweiler@chu-angers.fr. Robarts Research Institute, The University of Western Ontario, London, ON N6A 5B7, Canada. Cedric.Annweiler@chu-angers.fr.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29794977

Citation

Brangier, Antoine, et al. "Vitamin K Antagonists and Cognitive Decline in Older Adults: a 24-Month Follow-Up." Nutrients, vol. 10, no. 6, 2018.
Brangier A, Ferland G, Rolland Y, et al. Vitamin K Antagonists and Cognitive Decline in Older Adults: A 24-Month Follow-Up. Nutrients. 2018;10(6).
Brangier, A., Ferland, G., Rolland, Y., Gautier, J., Féart, C., & Annweiler, C. (2018). Vitamin K Antagonists and Cognitive Decline in Older Adults: A 24-Month Follow-Up. Nutrients, 10(6). https://doi.org/10.3390/nu10060666
Brangier A, et al. Vitamin K Antagonists and Cognitive Decline in Older Adults: a 24-Month Follow-Up. Nutrients. 2018 May 24;10(6) PubMed PMID: 29794977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin K Antagonists and Cognitive Decline in Older Adults: A 24-Month Follow-Up. AU - Brangier,Antoine, AU - Ferland,Guylaine, AU - Rolland,Yves, AU - Gautier,Jennifer, AU - Féart,Catherine, AU - Annweiler,Cedric, Y1 - 2018/05/24/ PY - 2018/03/22/received PY - 2018/04/29/revised PY - 2018/05/14/accepted PY - 2018/5/26/entrez PY - 2018/5/26/pubmed PY - 2018/10/10/medline KW - cognition KW - executive functions KW - older adults KW - vitamin K KW - vitamin K antagonist JF - Nutrients JO - Nutrients VL - 10 IS - 6 N2 - Vitamin K participates in brain physiology. This study aimed to determine whether using vitamin K antagonists (VKAs), which interfere with the vitamin K cycle, were (i) cross-sectionally associated with altered cognitive performance, and (ii) independent predictors of cognitive changes in older adults over 24 months. Information was collected on the use of VKAs (i.e., warfarin, acenocoumarol, and fluindione) among 378 geriatric outpatients (mean, 82.3 ± 5.6 years; 60.1% female). Global cognitive performance and executive functions were assessed with Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) scores, respectively, at baseline and after 12 and 24 months of follow-up. Age, gender, body mass index, mean arterial pressure, disability, gait speed, comorbidities, atrial fibrillation, stroke, carotid artery stenosis, leukoaraiosis grade on computed tomography (CT) scan, psychoactive drugs, antidementia drugs, blood-thinning drugs (i.e., anticoagulants other than VKAs, antiplatelet medications), serum creatinine levels, and vitamin B12 concentrations were considered as potential confounders. Using VKAs was associated with lower (i.e., worse) FAB score at baseline (adjusted β = -2.1, p = 0.026), and with a decrease in FAB score after 24 months (adjusted β = -203.6%, p = 0.010), but not after 12 months (p = 0.659). Using VKAs was not associated with any change in MMSE score at baseline (p = 0.655), after 12 months (p = 0.603), or after 24 months (p = 0.201). In conclusion, we found more severe executive dysfunction at baseline and incident executive decline over 24 months among geriatric patients using VKAs, when compared with their counterparts. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/29794977/Vitamin_K_Antagonists_and_Cognitive_Decline_in_Older_Adults:_A_24_Month_Follow_Up_ L2 - http://www.mdpi.com/resolver?pii=nu10060666 DB - PRIME DP - Unbound Medicine ER -